A federal lawsuit claims that UnitedHealth Group, the largest Medicare Advantage insurer in the country, is coding medical claims inappropriately for monetary gain. But while the lawsuit doesn't ...

A federal lawsuit has focused attention on how the industry uses medical codes for risk adjustment. While the lawsuit doesn’t involve physician practices, it’s a heads-up for them to pay attention to ...

Medicare open enrollment kicked off Friday with more Medicare Advantage plans to choose from but with renewed criticism that insurers are gaming risk adjustment practices to inflate profits. While ...

Joint customers can improve coding accuracy, strengthen compliant submissions, and strengthen RAF integrity with Penguin Ai's HCC Coding & Risk Adjustment Snowflake Native App PALO ALTO, Calif., Jan.

Claims data, which form the foundation of risk adjustment in payment for health care services, may reflect efforts to capture more—or more severe—clinical conditions rather than true changes in health ...

Talix has entered into a reseller agreement with NextGen Healthcare, Allscripts and Capstone Performance Systems to make Talix’s risk-adjusted coding solution available to customers on the companies’ ...

Healthcare risk management solutions company Talix has launched Coding InSight for Payers. Coding InSight for Payers is designed to help health plans automate and streamline risk adjustment processes ...

Datavant, the data collaboration platform trusted for healthcare, today announced that it has been named the #1 Ranked 2026 Best in KLAS Award winner in both the Risk Adjustment: Coding, Retrieval & ...